Reminder: New HCA preventable readmissions payment policy effective January 1

December 20, 2017

The Health Care Authority (HCA) and the Medicaid managed care plans will implement a new payment policy impacting Medicaid readmissions within 14 days after discharge. This new readmissions policy takes effect on January 1, 2018 and replaces the current policy that applied a payment rate penalty to hospitals with higher than average readmission rates. In conjunction with the new policy, HCA will adjust hospital rates on January 1 to remove the payment rate reduction penalties of the previous policy.

WSHA worked closely with a few key hospital leaders and HCA in this process. We obtained significant improvements in the final policy to provide adequate exclusion criteria and fair parameters for MCOs. For more information, see our previous Bulletin and an informational webcast recording. (Chelene Whiteaker,


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